Международный научно-образовательный электронный журнал «образование и наука в XXI веке». Выпуск №25 (том 2)

 
β (T-31C) polymorphism
 
on the formation of 
the Jurassic.
 
Thus, the analyzed distribution of genotypes of the rs 1143627 gene 
polymorphism revealed the independent nature of its association with the risk of 
serious disorders in children with JRA and proves the involvement of the rs 1143627 
allele variant in the pathogenetic mechanism of JRA development and course. 

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Polyarticular JRA was observed in 35 examined patients, 6 of whom were 
seropositive for rheumatoid factor. The seropositive subtype had a subacute onset with 
symmetrical polyarthritis. As a rule, the joints of the hand and feet were affected. 
Structural changes in the joints developed in the first 6 months of the disease. By the end 
of the first year of the disease, 2 patients developed ankylosis in the wrist joints. 1 patient 
developed destructive arthritis. According to the literature, this form of JRA is an early 
onset of adult rheumatoid arthritis. 
The seronegative subtype had a subacute onset, and symmetrical polyarthritis was 
also noted. The course of arthritis was relatively benign. 
Some features of the articular syndrome were established depending on the form of 
the disease, the nature of the course of JRA, gender and age of patients. Thus, the 
articular form of the disease with a subacute onset was accompaniedby the 
development of arthritis with a predominant lesion of the knee and ankle joints (68 and 
28%, respectively). In the future, the wrist and elbow joints were most often attached. 
At the same time, the process progressed moderately and productive changes 
prevailed. X-raylogically determined mainly IIgrade II according to Steinbrocker. In 
the acute onset of this variant of the disease, the wrist, metacarpophalangeal, and 
interphalangeal joints of the hand were often involved in the process.
The articular-visceral form was observed in 10 patients examined by us and was 
clinically characterized by a high temperature reaction, which is intermittent and does 
not decrease during antibiotic treatment. Against the background of fever, patients had a 
polymorphic rash of bright pink color. An increase in all groups of peripheral lymph 
nodes was characteristic. Several joints were involved in the process – knee, ankle, 
elbow, and neck. All the joints were painful and swollen. There was an increase in the 
size of the liver and spleen. 
In 4 patients, the disease occurred with kidney damage, in 3 patients with heart 
damage, in 1-with lung damage, in 2-combined lesions of internal organs were noted. In 
1 preschool-aged girl, the disease was Still syndrome - like, and in 1 boy, it was Wissler-
Fanconi syndrome-like. In systemic forms, the joint syndrome also had its own 
distinctive features. Thus, in one patient with an allergic-septic variant, the disease began 

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with persistent arthralgia in the large (knee, hip) and medium (ankle, wrist, and elbow) 
joints without visible changes in them. The duration of the arthralgia period without 
clearsigns of arthritis was 1.5 months in this patient. Then there were exudative and 
productive changes in the joints with the rapid development of usurs and erosions. The 
articular syndrome in Still's disease was most fully presented. One sick girl with this 
form of the disease developed generalized joint syndrome at the earliest stages, involving 
the joints of the hand, foot, neck, maxillofacial spine, as well as larger joints. The initial 
exudative phase was quicklyreplaced by productive processes, erosion and destruction 
of cartilage, which led to early ankylosis in the wrist joints. 
From the instrumental methods of research, we conducted an X-ray study, which 
allows us to judge the degree of joint damage and determine the stage of anatomical 
changes in accordance with the Steinbrocker criteria. In the first months of the disease, 
the main radiological indicator is epiphyseal osteoporosis, small-cystic reconstruction 
of the bone structure of the epiphysis. Then erosion occurs. The frequency of 
occurrence of JRA radiological criteria according to the Steinbrockera criteria is 
presented in Table 4